Cable-actuated jaw assembly for surgical instruments

ABSTRACT

A jaw assembly is provided with a pair of jaws which are closed with a flexible, tension member that is pulled by the operator of the instrument. In a preferred embodiment, one of the jaws is pivotally mounted in a slot to the other jaw. A cord, having a loop configuration, is attached to the pivoting jaw and can be pulled to pivot the jaw closed. A second cord can be provided to initially hold the proximal end of the pivoting jaw away from the other jaw until the distal ends of the jaws are closer together. In another embodiment, jaws can be closed in a parallel orientation by rotating two pulleys with threaded shafts engaged with the jaws.

This is a division of application Ser. No. 08/198,939, filed Feb. 18,1994, now U.S. Pat. No. 5,507,773.

TECHNICAL FIELD

This invention relates generally to surgical instruments and isespecially suitable for incorporation in various instruments used inendoscopic procedures as well as in open surgery procedures.

BACKGROUND OF THE INVENTION AND TECHNICAL PROBLEMS POSED BY THE PRIORART

A variety of designs have been commercialized or proposed forinstruments incorporating a pair of cooperating jaws (i.e., a jawassembly) in which one jaw pivots or otherwise moves relative to theother jaw between open and closed positions. Examples of suchinstruments include tissue graspers, tissue clamps, needle graspers,tissue cutters, linear staplers, ligating clip appliers, and the like.

In many surgical procedures, the working area is confined, andinstruments with relatively small cross sections are necessary orpreferred. Thus, it would be desirable to provide an improved jawassembly that can be incorporated in a surgical instrument and that hasa relatively small cross section.

Some instrument designs have been developed for linear stapler systemswherein one jaw functions as an anvil and the other jaw carries a row orrows of staples. The anvil jaw can be closed manually to trap layers oftissue between the two jaws. Then, a suitable mechanism is actuated todischarge the staples through the tissue and against the anvil jaw. Itwould be beneficial to provide an improved jaw assembly design thatcould readily accommodate a staple application system and permit openingand closing of the jaws remotely from the proximal end of theinstrument.

When pivotally-mounted jaws are employed to clamp or squeeze tissue, theproximal portions of the jaws typically engage the tissue before thedistal portions of the jaws engage the tissue. This can cause the tissueto be forced distally in the jaws, and the tissue may then not beproperly engaged by the jaws. It would be desirable to provide animproved jaw assembly that could close the jaws in a way that wouldeliminate or minimize the tendency of the tissue to move along the jawsas the jaws close.

In some surgical applications, it is necessary or advantageous to applyrelatively high squeezing forces. Thus, it would be desirable to providean improved jaw assembly that can provide a mechanical advantage forincreasing the jaw closure force compared to the operator input force.It would also be beneficial if the jaw assembly could accommodatedesigns wherein the closure force at the jaw assembly can be variedduring the closure stroke.

Additionally it would be advantageous to provide an improved jawassembly that could be incorporated in instruments used in endoscopicsurgical procedures as well as in instruments used in open surgeryprocedures. As used herein, the term "endoscopic" pertains generally tothe use of a surgical instrument which is inserted into a body cavity inconjunction with an endoscope that is inserted into the same bodycavity. The endoscope permits visual inspection, with or withoutmagnification, of the interior of the body cavity and permitsobservation of the operation of the surgical instrument for therapeuticor diagnostic purposes.

In a typical endoscopic surgical procedure, the abdominal cavity of ahuman or animal subject is insufflated with a sterile gas, such ascarbon dioxide, in order to provide increased maneuvering room withinthe body cavity for endoscopic instruments. Then, conventional trocarsare inserted into the subject's body cavity through the surroundingskin, tissue, and musculature. A conventional trocar typically consistsof a trocar cannula which houses an elongated trocar obturator. Trocarobturators typically have a piercing point, although other types ofobturators are also available.

After each trocar has been positioned within the body cavity adjacentthe target surgical site, the trocar obturator is removed leaving thetrocar cannula as a pathway to the body cavity. A plurality of trocarcannulas are typically placed in this manner. The surgeon can theninsert an endoscope through one of the trocar cannulas and can insertvarious types of endoscopic, surgical instruments through one or more ofthe other trocar cannulas at the target surgical site where thediagnostic or therapeutic surgical procedure is performed.

The endoscope is typically connected to a video camera, and the outputfrom the video camera is fed to a video monitor which displays thesurgical site and the end of the endoscopic instrument at the surgicalsite. Some endoscopic instruments incorporate a pair of jaws (e.g.,ligating clip appliers, tissue cutters, tissue graspers, needlegraspers, and the like). Thus, it would be desirable to provide animproved jaw assembly that can be employed in such endoscopicinstruments and that can easily accommodate operation and control fromthe proximal end of the instrument exterior of the body cavity.

Although endoscopic surgical procedures offer many advantages, there aresome problems associated with these procedures as conventionallypracticed. For example, because the surgeon typically views the displayon the video monitor as he manipulates instruments within the bodycavity, the video display provides the surgeon with only atwo-dimensional view of the surgical site, and there is a consequentloss of depth perception.

Another problem relates to engaging tissue from the instrument insertiondirection. Some conventional, endoscopic instruments (e.g., graspers)include a jaw assembly for engaging the tissue in a way that effects thedesired result (e.g., squeezing the tissue). In some of theseconventional, endoscopic instruments, the jaws are mounted to, andextend generally linearly with, a rigid, straight shaft of theinstrument.

Depending upon the nature of the operation to be performed on the tissuewithin the body cavity, it may be desirable to provide a jaw assemblywhich can be angled or articulated relative to the longitudinal axis ofthe instrument shaft. This can permit the surgeon to more easily engagethe tissue in some situations.

A further problem relates to the potential for blocking part of thefield of view with the endoscopic instrument. Thus, the use of anendoscopic instrument with an articulating distal end would permit thesurgeon to engage the tissue with the jaws laterally offset relative tothe instrument's main shaft. This would permit the engaged tissue andjaws to be better viewed through an adjacent endoscope with little or nointerference from the main shaft.

Although a number of designs have been proposed for articulatingendoscopic instruments, and although articulating endoscopes and otherinstruments are commercially available, it would be desirable to providean improved design for a remotely operated jaw assembly that canaccommodate articulation of the distal portion of the instrument towhich the jaw assembly is mounted.

In particular, it would be advantageous to provide a jaw assembly for anarticulating instrument (endoscopic or non-endoscopic) with thecapability for jaw operation even when the assembly is oriented at asubstantial oblique angle relative to the longitudinal axis of theinstrument. Further, it would be beneficial if such an improved designpermitted operation of the jaw assembly while the jaw assembly isarticulated in any radial direction around the longitudinal axis of theinstrument.

In endoscopic surgery it may be desirable in some situations to senseenvironmental characteristics at the surgical site (e.g., temperature,chemical, etc.). Further, it may be desirable to sense the actualpresence or position of a component of the instrument. In addition, itmay be beneficial to provide conduits for irrigation or aspiration atthe surgical site. It may also be necessary to provide clips or staplesat the site and to provide means, carried in the jaw assembly, forapplying the clips or staples. Accordingly, it would be especiallyadvantageous to provide an improved jaw assembly which can accommodateinternal sensor lines, aspiration conduits, irrigation conduits, andflexible actuator members, and which can also accommodate the feedingand application of fasteners (e.g., of clips and staples). Such animproved jaw assembly should preferably have sufficient interior spacethat can accommodate internal passages and components and that canpermit the movement of such components through the jaw assembly.

It would also be advantageous if such an improved jaw assembly for anendoscopic or open surgery instrument could be provided with arelatively smooth exterior configuration having a minimum ofindentations and projections that might serve as sites for contaminantsand be hard to clean or that might be more likely to catch on, or tear,adjacent tissue.

It would also be beneficial if such an improved jaw assembly could beprovided with sufficient strength to accommodate relatively high momentsand forces during operation of the instrument jaw assembly in anarticulated orientation as well as in a straight orientation.

The present invention provides an improved jaw assembly for aninstrument used in a surgical procedure which can accommodate designshaving the above-discussed benefits and features.

SUMMARY OF THE INVENTION

According to the principles of the present invention, a unique jawassembly is provided for a surgical instrument. The jaw assembly can bereadily incorporated in an articulating instrument where the jawassembly can be articulated relative to the rest of the instrument andcan still be operated to open and close the jaws. The jaw assembly isrelatively strong and can be operated to apply relatively high jawclosing forces.

The jaw assembly is readily operated from the proximal end of theinstrument without requiring the application of excessively high inputforces or torques.

Embodiments of the jaw assembly can be designed to provide a significantamount of internal clearance to accommodate components extending fromthe proximal end of the instrument through the jaw assembly. Theinternal region of the jaw assembly can also be designed to accommodatethe passage of fasteners, such as ligating clips or staples.

The jaw assembly design can also be incorporated in embodiments whereinthe tissue is compressed between substantially parallel jaws or betweenthe distal ends of pivoting jaws so as to eliminate or minimize themovement of the tissue relative to the jaws when the jaws close.

The jaw assembly can be provided with a relatively smooth exteriorconfiguration to minimize potential contamination sites or tissuesnagging sites.

According to the teachings of the present invention, the jaw assemblyincludes a pair of jaws which are closed with a flexible, tension memberthat is pulled by the operator of the instrument. Such a flexibletension member may be a unitary or composite cord, cable, thin strip ofmetal or plastic, string, filament, or the like having a single strandor element as well as multiple strands or elements. Such a flexible,tension member transmits applied tension force but is typicallyineffective to transmit any substantial compressive force. Forconvenience, the term "cord" is used throughout this specification andin the claims to broadly denote such a flexible, tension member.

In one form of the invention, a pair of jaws is provided in which onejaw is movable relative to the other. The jaws are actuated with anoperating cord. The cord defines a loop having one portion operativelyengaged with the movable jaw and another portion adapted to be engagedso as to apply tension to at least part of the loop to effect movementof the movable jaw. The use of an endless loop construction isespecially advantageous with some types of cord materials wherein it isdifficult to securely attach a cord end to instrument components becauseof cord brittleness or lubricity (e.g., liquid crystal materials orthermoplastic, polymer materials having a relatively low coefficientsliding friction).

In one embodiment of the invention, the assembly includes a first jawhaving a distal end and a proximal end and includes a movable second jawhaving a distal end and a proximal end. The second jaw is mounted forpivoting movement about a pivot axis toward and away from the first jaw.An operating cord is engaged with the second jaw distally of the pivotaxis for pulling the second jaw to pivot the distal end of the secondjaw toward the first jaw.

In some applications it is desirable to provide a second operating cord.The second operating cord is engaged with the second jaw and is arrangedto pull the second jaw proximal end away from the first jaw when thesecond operating cord is tensioned. If the second operating cord istensioned when the first operating cord is initially pulled, then theproximal end of the second jaw is initially held away from the first jawso that the distal end of the second jaw moves toward the first jaw andengages the material between the jaws before the proximal end of thesecond jaw engages the material. This minimizes the tendency of thetissue to be moved distally along the jaws during the closure of thejaws.

In one preferred embodiment, the jaw assembly also includes a leverwhich has a lever pivot axis and which is mounted for pivoting movementabout the lever pivot axis. The lever defines first and second surfacesfor engaging the cord. The distance between the lever pivot axis and anypart of the first surface is less than the distance between the leverpivot axis and any part of the second surface. When the cord is pulled,the lever pivots to change the length of the lever arm through which thecord acts. This assembly can be arranged so that the second jaw is firstpulled by the cord with lower force through a longer range of movementand is subsequently pulled with higher force through a shorter range ofmovement.

In another embodiment, the jaw assembly also includes a first jaw havinga distal end and a proximal end, as well as a movable second jaw havinga distal end and a proximal end. One of the jaws defines an elongateslot adjacent its proximal end. The other jaw has a transverselyextending shaft adjacent its proximal end and received in the slot formounting the jaws together to accommodate translation and pivotingmovement of the second jaw toward and away from the first jaw.

A spring is provided to bias the second jaw relative to the first jawfor urging the second jaw to pivot away from the first jaw.

A first operating cord is engaged with the second jaw at a firstlocation distally of the shaft for pulling the second jaw to pivot thesecond jaw distal end toward the first jaw. The first operating cord isalso engaged with the second jaw at a second location proximally of thefirst location for urging the second jaw proximal end away from thefirst jaw only during an initial portion of the pivoting movement of thesecond jaw distal end toward said first jaw. This permits the tissue tobe initially engaged between the distal ends of the jaws so as tominimize the tendency of the tissue to be moved distally along the jawsduring the closure of the jaws.

In another embodiment, the jaw assembly includes first and second jawswith at least one of the jaws being movable toward the other. A springstructure is provided for urging the jaws apart. The first jaw has alateral guide surface. An operating cord defining a U-shaped loopconfiguration is engaged with the second jaw. The cord has at least onetrailing portion extending around the lateral guide surface whereby thetrailing portion can be pulled to urge at least one of the jaws towardthe other of the jaws.

Another form of the jaw assembly includes a first jaw and a first guidesurface fixed relative to the first jaw. A movable second jaw having asecond guide surface is mounted for pivoting movement toward and awayfrom the first jaw. A spring biases the second jaw relative to the firstjaw for urging the second jaw to pivot away from the first jaw. A cordis provided with a portion fixed relative to the first jaw. The cord hasa trailing portion trained sequentially from the fixed portion aroundthe second guide surface and then around the first guide surface forpulling the second jaw to pivot toward the first jaw.

Another embodiment of the jaw assembly also has a first jaw with adistal end and a proximal end, as well as a movable second jaw having adistal end and a proximal end. One of the jaws defines an elongate slotadjacent its proximal end. The other jaw has a transversely extendingshaft adjacent its proximal end and received in the slot for mountingthe jaws together to accommodate translation and pivoting movement ofthe second jaw toward and away from the first jaw.

A spring biases the second jaw relative to the first jaw for urging thesecond jaw proximal end to translate away from the first jaw and to alsourge the second jaw distal end to pivot away from the first jaw.

An operating cord is connected with the second jaw at a first locationdistally of the shaft for pulling the second jaw to pivot the second jawdistal end toward the first jaw. The operating cord is also engaged withthe second jaw at a second location proximally of the first location forurging the second jaw proximal end toward the first jaw as the secondjaw distal end moves toward the first jaw.

In another embodiment, the jaw assembly also includes a first jaw havinga distal end and a proximal end as well as a movable second jaw providedwith a distal end and a proximal end. One of the jaws defines anelongate slot adjacent its proximal end. The other jaw has atransversely extending shaft adjacent its proximal end and received inthe slot for mounting the jaws together to accommodate translation andpivoting movement of the second jaw toward and away from the first jaw.

A first operating cord is engaged with the second jaw at a firstlocation distally of the shaft for pulling the second jaw to pivot thesecond jaw distal end toward the first jaw. The first operating cord isalso engaged with the second jaw at a second location proximally of thefirst location for urging the second jaw proximal end away from saidfirst jaw only during an initial portion of the pivoting movement of thesecond jaw distal end toward the first jaw.

A second operating cord is engaged with the second jaw proximal end.Pulling the second cord urges the second jaw proximal end toward thefirst jaw with concomitant relative displacement between the shaft andslot.

In yet another embodiment, the jaw assembly includes a frame and a firstjaw projecting transversely from the frame. A second jaw is carried onthe frame for movement toward and away from the first jaw in anorientation fixed relative to the first jaw.

A first guide member is carried on either the first jaw or frame. Asecond guide member is carried on the second jaw. A slot is defined byeither the frame or the second jaw. A pin is carried on the other of theframe and second jaw such that the pin is received in the slot toaccommodate movement of the second jaw.

A spring biases the second jaw away from the first jaw. A cord isconnected to the first jaw. The cord is trained sequentially from thefirst jaw around the second guide member and then around the first guidemember. The cord extends from the first guide member proximally of thejaw assembly whereby the pulling of the cord effects the closure of thejaws.

A similar frame is also provided as part of yet another embodiment inwhich a first jaw projects transversely from the frame. A second jaw iscarried on the frame for movement toward and away from the first jaw inan orientation fixed relative to the first jaw. A guide member iscarried on either the first jaw or frame. A slot is defined by eitherthe frame or second jaw. A pin is carried on the other of the frame andsecond jaw and is received in the slot to accommodate movement of thesecond jaw.

A spring biases the second jaw away from the first jaw. A cord isconnected to the second jaw. The cord extends around the guide memberand extends proximally of the jaw assembly whereby the pulling of saidcord effects the closure of the jaws.

Another form of the jaw assembly includes at least a first rod having afirst axial portion defining a right-hand thread and a second axialportion defining a left-hand thread. The assembly also includes a firstjaw defining a first right-hand threaded bore for receiving andthreadingly engaging the first rod first axial portion. The assemblyfurther includes a second jaw defining a first left-hand threaded borefor receiving and threadingly engaging the first rod second axialportion. A cord is operatively associated with the first rod to applytorque to the rod and effect rotation of the rod when the cord ispulled. This causes the jaws to move toward or away from each otherdepending upon the direction of rotation of the rod.

The jaw assembly in another embodiment includes a first jaw having adistal end and a proximal end, and includes a movable second jaw havinga distal end and a proximal end. The second jaw is mounted for pivotingmovement about a pivot axis toward and away from the first jaw. A rolleris carried on the second jaw. A cord, which includes the distal endportion in the form of a flexible, metallic band, is engaged with thesecond jaw distally of the pivot axis and is trained around the roller.The band has a generally Z-shaped configuration. A spring can beprovided in the jaw assembly to urge the second jaw to pivot and carrythe distal end of the second jaw away from the first jaw. Pulling on thecord effects closure of the jaws.

Another embodiment of the jaw assembly is similar to the embodimentdescribed immediately above. It differs in that the band is secured tothe distal end of the second jaw, and a second roller is carried on thesecond jaw. A flexible, metallic band is trained around the first andsecond rollers.

Another embodiment of the jaw assembly includes a first jaw having adistal end and a proximal end, and a second jaw having a distal end anda proximal end. One of the jaws defines an elongate slot adjacent itsproximal end, and the other jaw has a transversely extending shaftadjacent its proximal end. The shaft is received in the slot formounting the jaws together to accommodate translation and pivotingmovement of the second jaw toward and away from the first jaw. The firstjaw has a first guide pin located distally of the slot and a secondguide pin located proximally of the slot. The second jaw has a thirdguide pin located distally of the slot.

A spring biases the second jaw relative to the first jaw for urging thesecond jaw to pivot relative to the first jaw to an open position. Theassembly also includes a first operating cord which has at least a firstportion extending into the first jaw from the proximal end of the firstjaw. The first cord first portion extends between, and engages, thefirst jaw second guide pin and the shaft in the slot. The first cordfirst portion extends distally from the shaft and sequentially aroundthe first guide pin on the first jaw and then around the third guide pinon the second jaw. The first cord first portion extends from the thirdguide pin on the second jaw to, and is engaged with, the first jaw at alocation spaced from the first guide pin.

A second operating cord is connected to the proximal end of the secondjaw to assist in operating the second jaw. It can be pulled at theproper time during the pulling of the first cord. The tension on thesecond cord initially holds the proximal end of the second jaw away fromthe first jaw so that the distal end of the second jaw closes first.

Numerous other advantages and features of the present invention willbecome readily apparent from the following detailed description of theinvention, from the claims, and from the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the accompanying drawings that form part of the specification, and inwhich like numerals are employed to designate like parts throughout thesame,

FIG. 1 is a simplified, exploded, perspective view of the distal end ofportion of an instrument which includes a first embodiment of the jawassembly of the present invention;

FIG. 2 is a simplified, schematic representation of the proximal portionof the instrument showing the handle and a lever for operating the jaws;

FIG. 3 is a fragmentary, top plan view of the jaw assembly illustratedin FIG. 1, but FIG. 3 shows the jaw assembly in an open position withportions of the upper or second jaw cut away to illustrate interiordetail;

FIG. 4 is a fragmentary, cross-sectional view taken generally along theplane 4--4 in FIG. 3;

FIG. 5 is a view similar to FIG. 4, but FIG. 4 shows a partially closedcondition of the jaw assembly;

FIG. 6 is a view similar to FIG. 5 but shows a completely closedcondition of the jaw assembly;

FIG. 7 is a fragmentary view similar to FIG. 3 and shows the jawassembly in an articulated position at an oblique angle relative to theinstrument longitudinal axis;

FIG. 8 is a fragmentary, cross-sectional view of a second embodiment ofa jaw assembly in an open position;

FIG. 8A is a cross-sectional view taken generally along plane 8A--8A inFIG. 8;

FIG. 8B is a fragmentary, cross-sectional view taken generally along theplanes 8B--8B in FIG. 8;

FIG. 9 is a view similar to FIG. 8, but FIG. 9 shows the jaw assembly ina partially closed condition;

FIG. 10 is a view similar to FIG. 9, but FIG. shows the jaw assembly ina fully closed condition;

FIG. 11 is a fragmentary, exploded, perspective view of a thirdembodiment of a jaw assembly;

FIG. 12 is a fragmentary, perspective view of the jaw assembly of FIG.11 shown in the assembled condition;

FIG. 13 is a view similar to FIG. 12, but FIG. 13 shows a fourthembodiment as modification of the jaw assembly illustrated in FIG. 12;

FIG. 14 is a fragmentary, cross-sectional view of a fifth embodiment ofa jaw assembly in an open condition;

FIG. 15 is a view similar to FIG. 14, but FIG. 15 shows the jaw assemblyin the closed condition;

FIG. 16 is a fragmentary, cross-sectional view of a sixth embodiment ofa jaw assembly;

FIG. 17 is a view similar to FIG. 16, but FIG. 17 shows the jaw assemblyin a closed condition;

FIG. 18 is a fragmentary, cross-sectional view of a seventh embodimentof a jaw assembly;

FIG. 18A is a fragmentary view similar to FIG. 18, but FIG. 18A showsthe side of the jaw assembly opposite from that visible in FIG. 18;

FIG. 19 is a fragmentary, bottom view of the jaw assembly takengenerally along the plane 19--19 in FIG. 18;

FIG. 20 is a fragmentary, side elevational view of an eighth embodimentof a jaw assembly with portions of the assembly broken away and shown incross section to illustrate interior detail;

FIG. 20A is a cross-sectional view taken generally along the plane20A--20A in FIG. 20;

FIG. 20B is a view similar to FIG. 20 but shows the jaw assembly in aclosed condition;

FIG. 21 is a fragmentary, side elevational view of a ninth embodiment ofa jaw assembly with portions of the assembly cut away and shown in crosssection to illustrate interior detail;

FIG. 22 is a fragmentary, cross-sectional plan view of a tenthembodiment of a jaw assembly;

FIG. 23 is a fragmentary, cross-sectional view taken generally along theplane 23--23 in FIG. 22;

FIG. 24 is a view similar to FIG. 22, but FIG. 24 shows the jaw assemblyin a closed condition;

FIG. 25 is a fragmentary, exploded, perspective view of an eleventhembodiment of a jaw assembly;

FIG. 26 is an exploded, perspective view of a twelfth embodiment of ajaw assembly;

FIG. 27 is a fragmentary, perspective view of a thirteenth embodiment ofa jaw assembly;

FIG. 28 is a view similar to FIG. 27, but FIG. 28 shows the jaw assemblypartially closed;

FIG. 29 is a view similar to FIG. 28, but FIG. 29 shows the jaw assemblyin the fully closed condition; and

FIG. 30 is a cross-sectional view taken generally along the plane 30--30in FIG. 27.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

One aspect of the present invention relates to a jaw assembly which canbe incorporated in a variety of designs providing unique operationalcharacteristics and capabilities. In particular, the jaw assembly isreadily adapted for use at the distal end of an instrument which can bearticulated. The jaw assembly is operable during and after articulation.

Further, some embodiments of the jaw assembly provide a mechanicaladvantage for increasing jaw force. In addition, some embodiments of thejaw assembly effect closure of the jaws by moving the jaws in acontinuously parallel orientation. Other embodiments effect closure bymoving the distal end of one of the jaws to a closed location before theproximal portion of the jaw is fully moved to a closed location. Thisminimizes the movement of tissue along the jaws during the jaw closingprocess.

The jaw assembly is relatively strong and can be provided with anexterior configuration that minimizes structural projections that mightsnag on tissue or accumulate contaminants.

In addition, the jaw assembly can be employed in instruments withdevices for effecting a variety of functions with respect to thesurgical site. Such functions can include, but are not limited to,grasping, clamping, applying staples or ligating clips, applyingultrasonic energy, irrigating the surgical site, or removing materialfrom the site by aspiration or suction.

Various embodiments can be provided with sufficient interior space toaccommodate internal passages and components (e.g., sensor lines,conduits, fastener actuation systems, etc.). Components for varioussensor systems can be routed through the novel jaw assembly. Such sensorsystems can include, but are not limited to, systems for measuringtissue thickness or compression, tumor sensing, pulse oximetry, anddopplar effect sensing of fluid in vessels. Also, light guides and otherfiber optic system components may be routed through the assembly.

Further, the jaw assembly of the present invention accommodates variousdesigns for venting or sealing the instrument in which the jaw assemblyis incorporated, and the jaw assembly design accommodates the use offilters for filtering gas and smoke.

While this invention is susceptible of embodiment in many differentforms, this specification and the accompanying drawings disclose onlysome specific forms as examples of the invention. The invention is notintended to be limited to the embodiments so described, however. Thescope of the invention is pointed out in the appended claims.

For ease of description, the jaw assembly embodiments of this inventionare described in various operating positions, and terms such as upper,lower, horizontal, etc., are used with reference to these positions. Itwill be understood, however, that jaw assemblies incorporating thisinvention may be manufactured, stored, transported, used, and sold in anorientation other than the position described.

Figures illustrating the jaw assemblies show some mechanical elementsthat are known and that will be recognized by one skilled in the art.The detailed descriptions of such elements are not necessary to anunderstanding of the invention, and accordingly, are herein presentedonly to the degree necessary to facilitate an understanding of the novelfeatures of the present invention.

The jaw assemblies incorporating the present invention can be used ininstruments that have certain conventional components the details ofwhich, although not fully illustrated or described, will be apparent tothose having skill in the art and an understanding of the necessaryfunctions of such components.

FIGS. 1-7 schematically illustrate some basic features of a firstembodiment of the jaw assembly of the present invention. The jawassembly is adapted to be mounted to a proximal portion of an opensurgery or endoscopic instrument, and the proximal portion may typicallybe a support housing 34 (FIG. 2). This part of the instrument is graspedby the surgeon. In an endoscopic instrument, the proximal part of thehousing 34 remains outside of the patient while the rest of theinstrument is inserted through the trocar cannula (not illustrated) andinto the body cavity.

The jaw assembly can be pivotally mounted to the instrument, and to thisend the instrument includes a mounting assembly 40 (FIG. 1) comprising abottom bracket 42, a top bracket 44, and a support member 46. The lowerbracket defines a bore 48, the upper bracket 44 defines a bore 50, andthe support member 46 defines a bore 52. The components are assembled sothat the bores 48, 52, and 50 are aligned to receive a hinge pin orpivot pin 54 (FIGS. 1 and 4). The proximal portions of the lower bracket42 and upper bracket 44 are adapted to be mounted in a shaft tube 47extending from the housing 34 by suitable means (not illustrated).

The support member 46 defines a cantilevered tongue 56 on which the jawassembly is mounted. To this end, the jaw assembly includes a first orlower jaw 61 having a proximal portion in the form of a channel definedby a first side wall 64 (FIG. 1), a second side wall 66 (FIG. 1), and abottom wall or floor 68 (FIG. 4). The projecting tongue 56 of thesupport member 46 is received within the proximal portion of the firstjaw 61 as shown in FIG. 4 and is retained therein by suitable means(e.g., threaded fasteners, press fit, adhesive, welding or brazing, andthe like (not illustrated)). The particular means by which the jawassembly is attached to the tongue 56 or to any other portion of aninstrument as may be desired, forms no part of the present invention.

The first jaw side wall 64 defines an aperture 69, and the first jawside wall 66 defines an aperture 70. An oval lever arm 74 is disposed ona pin 72 which is mounted in the apertures 69 and 70 in the first jaw61.

The jaw assembly includes an upper or second jaw 76 which has a proximalend portion defining a pair of bosses or ears 78. Each boss 78 defines abore 80. The proximal portion of the second jaw 76 is received betweenthe first jaw side walls 64 and 66. Each side wall 64 and 66 defines avertically oriented, elongate slot 84. A shaft 86 is mounted through theslots 84 and through the second jaw bores 80 so as to retain the secondjaw 76 mounted on the first jaw 61.

The length of each slot 84 is greater than the diameter of the shaft 86.The shaft 86 is thus free to translate vertically within the slots 84.This accommodates movement of the proximal portion of the second jaw 76toward and away from the first jaw 61. Further, the shaft 86 may becharacterized as defining a pivot axis about which the second jaw 76 canpivot. This pivot axis is, of course, not fixed and can translaterelative to the first jaw 61 as the shaft 86 moves along the slots 84.

In the preferred embodiment illustrated, a spring 90 is mounted withinthe jaw assembly as illustrated in FIGS. 1 and 4. The spring 90 has agenerally U-shaped configuration with the legs of the U bent over todefine cradle portions 92 which engage the shaft 84 so as to bias theshaft, and hence the proximal end of the second jaw 76, upwardly awayfrom the first jaw 61.

A cord 96 is provided for operating the jaw assembly to close the jaws.As discussed in greater detail under the section entitled "SUMMARY OFTHE INVENTION," the term "cord" is used herein to refer generally to aflexible, tension member such as a cable, string, filament, thin stripof metal or plastic, or the like. The cord 96 may be a unitary orcomposite structure having a single strand or element. The cord 96 mayalso incorporate multiple strands or elements. Such structures andcompositions may also be employed in cords used in the other jawassembly embodiments described in detail hereinafter.

In the presently contemplated preferred embodiment, the cord 96 is asingle loop of liquid crystal, polymer material having a relatively lowcoefficient of sliding friction. By using a continuous loop of thematerial, it is not necessary to attach or terminate a single end of thecord 96 to a component in the instrument. This is advantageous in thecase of some types of cord materials wherein it is difficult to securelyattach a cord end to instrument components. Such a loop structure mayalso be employed with cords used in other jaw assembly embodimentsdescribed in detail hereinafter.

The cord 96 defines a generally U-shaped configuration around the secondjaw 76 and extends from the second jaw 76 around the lever 74. The cord96 extends from the lever 74 beyond the proximal end of the jaw assemblywhere it may be pulled by a suitable means. In the embodimentillustrated in FIGS. 1-7, the instrument support member 46 defines anaperture 98 through which the cord 96 can extend proximally from thejaws 61 and 76. The cord 96 preferably extends to a proximal portion ofthe instrument, such as to the proximal end of the housing 34 (FIG. 2)where it can be pulled by the surgeon.

A presently preferred system for pulling the cord 96 is illustrated inFIG. 2 and comprises an L-shaped lever 100 pivotally mounted with a pin102 to the housing 34. The loop of cord 96 extends through an aperture104 in the operating lever 100. Because the spring 90 normally biasesthe second jaw 76 to the open position, the cord 96 is normally pulleddistally so as to pull the operating lever 100 to a forward positionagainst some suitable stop (not illustrated) in the housing 34. Thesurgeon can hold the proximal end of the housing 34 and squeeze thelever 100 rearwardly to pull the loop cord 96 proximally.

The distal end of the loop defined by the cord 96 is engaged with thesecond jaw 76. To this end, the outer surface of the second jaw 76defines an arcuate groove 108 (FIG. 4)in which the cord 96 is seated.The cord 96 extends down both sides of the second jaw 76 into thechannel section of the first jaw 61. The cord 96 is trained around, andengaged with, the exterior surface of the oval lever 74.

The lever 74 need not necessarily be oval but should have a firstsurface 111 and a second surface 112 (FIG. 4) wherein the distancebetween the lever pivot axis and any part of the first surface 111 isless than the distance between lever pivot axis and any part of thesecond surface 112. Preferably, the lever 74 is initially installed andengaged with the cord 96 such that the lever 74 has the orientationshown in FIG. 4 when the second jaw 76 is fully open. In particular, inthis condition, the longest portion of the lever 74 (e.g., the majoraxis of an oval-shaped lever) is oriented generally parallel to thelower jaw 61 and is generally parallel to the length of the instrumentalong which the proximal portion of the loop of cord 96 is pulled. Thecord 96 extending between the lever 74 and the second jaw 76 defines anangle of almost 90° with respect to the length of cord 96 extendingproximally from the lever 74.

When the cord 96 is pulled proximally, the length of cord along thefirst surface 111 applies tension through a relatively short lever armwhile the portion of the cord along the second surface 112 appliestension through a relatively long lever arm. As the cord 96 is pulledproximally, the lever 74 pivots (counterclockwise as viewed in FIG. 4).As the lever pivots to the intermediate position illustrated in FIG. 5,the length of cord 96 between the lever 74 and second jaw 76 issubjected to a relatively long travel at a relatively lower force. Asthe cord 96 continues to be pulled proximally from the orientationillustrated in FIG. 5 to the orientation illustrated in FIG. 6, theportion of the cord 96 engaged with the first surface 112 appliestension through a relatively long lever arm while the portion of thecord extending from the lever arm 74 to the second jaw 76 is tensionedthrough a relatively short lever arm. Thus, the travel of the cord 96adjacent the second surface 112 is translated into a shorter travel andis subjected to a higher force.

The effect of the operation of the jaw assembly is to initially move thesecond jaw 76 through a relatively large percentage of the distancetoward the closed position at relatively low force and to subsequentlypivot the second jaw 76 through a short, remaining arc to the fullyclosed position at a relatively high force. For example, if the lever 74is elliptical, and if the length of the major axis is equal to twice thelength of the minor axis, then the second jaw 76 will be initiallypulled toward the fully closed position with a force equal to 1/2 of theinput pulling force and will pivot through an arc (as measured at theradius where the cord 96 engages the top of the second jaw 76) having alength equal to twice the initial pulling stroke length. Subsequently,when the lever 76 has pivoted about 90° (to the position illustrated inFIG. 5), the second jaw 76 will apply a clamping force equal to twicethe pulling force as the second jaw 76 moves through an arc length equalto 1/2 of the final pull stroke length.

With reference to FIG. 4 and 5, it will be appreciated that during aninitial pivoting movement of the second jaw 76, the proximal end of thesecond jaw 76 remains substantially elevated because the spring 90 isbiasing the shaft 86 upwardly in the slots 84. Thus, as illustrated inFIG. 5, the distal end of the second jaw 76 initially engages material(e.g., two layers of tissue T1 and T2) before the more proximal portionsof the jaw 76 can engage the material. This tends to initially clamp thematerial between the distal ends of the two jaws and eliminate orminimize the normal tendency of material to move along conventional jawswhich pivot closed about a fixed pivot axis.

After the distal portion of the second jaw 76 has been pivoted to thesubstantially closed position, further force exerted by the pulling cord96 is sufficient to overcome the force of the spring 90, and theproximal end of the second jaw 76 is pulled toward the first jaw 61until the jaw assembly is completely closed as illustrated in FIG. 6.

The jaw assembly illustrated in FIGS. 1-7 can be used in an articulatingsurgical instrument. Because the jaw assembly is mounted, via the firstjaw 61, to the tongue 56 of the pivotal support member 46, the jawassembly moves with the support member 46 as it pivots about the axisdefined by the pin 54. An articulated orientation of the jaw assembly onthe support member 46 is illustrated in FIG. 7. The support member 46can be pivoted relative to the brackets 42 and 44 in which it is mountedby any suitable means. For example, a pulley (not illustrated) can befixed to the support member 46, and a drive belt or cord can be trainedaround the pulley. The drive belt or cord can be driven from theproximal end of the instrument by suitable means, such as a manuallyoperated knob, motor, or other appropriate device. The particularmechanism or system for effecting pivoting of the support member 46forms no part of the present invention.

The first jaw 61 and second jaw 76 are shown as having generally soliddistal end portions. It will be appreciated that one or both of the jawsmay have other configurations and may include hollow portions. Indeed,one or both of the jaws may include auxiliary components for acting onthe tissue that is adjacent or clamped between the jaws. For example,one or both of the jaws could incorporate sensor lines, aspirationconduits, irrigation conduits, and the like.

Further, the jaws may be adapted to apply tissue fasteners, such asclips or staples. For example, the first jaw 61 may be provided with astaple cartridge having a row or rows of staples, and the second jaw 76may incorporate an anvil design so that both jaws can function as alinear stapler. A suitable mechanism can be provided in thestaple-carrying jaw to discharge the staples through the tissue againstthe anvil jaw. Such a mechanism could be operated by means of anactuating member extending from the proximal end of the instrument intothe staple-carrying jaw. Linear stapler designs which may be suitablefor adaptation and incorporation into the jaw assembly of the presentinvention are illustrated in the U.S. Pat. No. 4,610,383.

In the jaw assembly first embodiment described above, as well as in theother embodiments described hereinafter, the particular design of theportion of each jaw that engages the tissue and/or that containsauxiliary components of the type described above forms no part of thepresent invention. Further, it will be appreciated that the entire jawassembly can be mounted in a fixed, as well as pivotable, arrangement tothe distal end of an instrument (not shown). In this embodiment, as wellas in other embodiments described hereinafter, the particular design ofthe structure for mounting the jaw assembly to the instrument forms nopart of the present invention.

Another embodiment of the jaw assembly of the present invention isillustrated in FIGS. 8, 8A, 8B, 9, and 10. The jaw assembly has a firstjaw 121 and a second jaw 122. Each jaw has a distal end and a proximalend. The jaws 121 and 122 are mounted together at their proximal ends.

The first jaw 121 has a pair of spaced-apart walls 124 (FIGS. 8A and8B), and each wall defines a fixed, elongated slot 126 (FIG. 9). Thesecond jaw 122 defines a downwardly depending central wall 127 in whichis mounted a shaft 130 (FIG. 9). The opposite ends of the shaft 130 arereceived in one of the a slots 126 defined in each adjacent side wall124 of the first jaw 121. The shaft 130 defines a pivot axis about whichthe second jaw 122 pivots relative to the first jaw 121. The shaft 130can translate along the length of each slot 126 so that the proximal endof the second jaw 122 can move toward and away from the first jaw 121.

The central wall 127 of the second jaw 122 includes a first pin orroller 132 at a first location distally of said shaft 130, and the pinor roller 132 has two end portions projecting in opposite directionsfrom the second jaw central wall 127 (FIG. 8A). Further, on each side ofthe second jaw central wall 127 there is a roller 136 mounted on theshaft 130.

The first jaw 121 defines a guide portion in the form of a fixed firstpin 140 which extends between the first jaw walls 124. A second pin 142(FIGS. 8-10) is mounted proximally of the slot 126 between the first jawwalls 124. Spaced above the second pin 142 is a third pin 144 which isalso mounted between the walls 124 of the first jaw 121.

A pair of V-shaped springs 148 are provided in the jaw assembly tonormally bias the second jaw 122 to an open position (as shown in FIG.8). One spring 148 is mounted on one side of the second jaw central wall127, and the other spring 148 is mounted on the other side of thecentral wall 127. Each spring 148 is mounted so that the interior angleat the apex of the V-shaped configuration of the spring receives theroller 136 on the shaft 130. The upper leg of each spring 148 is biasedoutwardly against the second jaw first roller or pin 132, and the end ofthe other leg of each spring is biased outwardly against the first jawfirst pin 140. This arrangement tends to continuously bias the secondjaw 122 toward the open position.

The jaw assembly includes a first operating cord 151 which can be pulledfrom the proximal end of the instrument to pivot the second jaw 122 fromthe open position (FIG. 8) to the closed position (FIG. 10). Inparticular, the cord 151 has a generally U-shaped configuration aroundthe first jaw 121 as illustrated in FIG. 8A. The first jaw 121 has abottom wall 153 (FIG. 8A) which defines a transverse groove 154 andwhich defines two spaced-apart apertures 155 establishing communicationbetween each end of the groove 154 and the interior of the first jaw121.

The first cord 151 is seated within the groove 154, and portions of thecord 151 extend up through each aperture 155 on each side of the secondjaw central wall 127. The cord is trained sequentially around the secondjaw first roller 132, around the first jaw first pin 140, around thesecond jaw second roller 136, and finally around the first jaw secondroller 142. The first cord 151 extends along both sides of the jawassembly through an aperture 158 in the proximal portion of the firstjaw 121. The two proximally extending lengths of the first cord 151 maythen be routed to the proximal portion of the instrument to a locationat which tension may be applied. The proximally extending lengths of thecord 151 can be joined together to form a continuous loop (FIG. 8B) andmay be attached in the proximal portion of the instrument to anoperating lever (e.g., similar to the lever 100 of the first embodimentof the jaw assembly described above with reference to FIG. 2).Alternatively, each proximally extending length of the cord 151 may beseparately terminated at the proximal portion of the instrument to alever or other device for pulling the cords proximally. The cord mayeven be manually grasped and pulled.

A second operating cord 160 is provided to pull on the proximal end ofthe second jaw 122. To this end, the proximal end of the second jaw 122has a transversely projecting pin 162, and the second operating cord 160is formed into a loop around the pin 162. The two lengths of the cord160 extend proximally from the pin 162 between the first jaw pins 144and 142 and through the first jaw aperture 158.

The proximally extending lengths of the second operating cord 160 extendto the proximal portion of the instrument along with the lengths of thefirst operating cord 151. As with the first operating cord 151, thesecond operating cord 160 is intended to be pulled or tensioned at theproximal end of the instrument by suitable means (not illustrated). Thesecond operating cord 160 may be directly grasped and pulled or thesecond operating cord 160 may be engaged with a device operable by thesurgeon for pulling the cord 160. The particular means for pulling thecord 160 form no part of the present invention.

The lengths of the second operating cord at the proximal end of theinstrument may be joined together, as shown in FIG. 8B, so as to form acontinuous loop. This permits engagement with a surgeon's finger, orwith other mechanisms for pulling the loop, without the necessity ofterminating separate cord end portions.

The first operating cord 151 and the second operating cord 160 may beprovided in any of the compositions and constructions that have beendescribed above for the cord 96 in the first embodiment of the jawassembly illustrated in FIGS. 1-7.

The jaw assembly illustrated in FIGS. 8, 8A, 8B, 9, and 10 may beoperated to provide a loading bias relative to the distal end of thejaws which is proportional to the total closure force applied and to theamount of closure. The jaw assembly initially loads the distal end ofthe second jaw 122 with a fraction of the total closure force generated.Subsequently, the fraction of the total closure force increases as thesecond jaw 122 closes further and as the tissue reaction forcesincrease.

The initially open condition of the jaw assembly is established bypulling the second operating cord 160 to pivot the second jaw 122upwardly relative to the first jaw 121. In this condition, the shaft 130is urged against the bottom of the first jaw slots 126. The springs 148,acting between the first jaw pin 140 and the second jaw pin or roller132, also force the jaws apart and insure that the first operating cable151 is extended.

In order to initiate the closing of the jaws, the tension on the secondoperating cable 160 is released or partially released. The jaw openingsprings 148 then move the proximal end of the first jaw 121 and theproximal end of the second jaw 122 further apart. This results in thesecond jaw shaft 130 moving upwardly to the upper end of the second jawslots 126. The tension in the first operating cable 151 exerts an upwardforce on the shaft 130. As the tension in the first operating cable 151is increased, the second jaw 122 pivots about the shaft 130 to lower thedistal end of the second jaw 122 toward the first jaw 121 (FIG. 9).

Typically, tissue has been located between the jaws, and the distal endof the second jaw 122 engages the tissue and applies an increasing loador force on the tissue. As the tissue is compressed, the total reactionforces on the distal end of the second jaw 122 increase, and the firstoperating cord 151 must be pulled with increasingly greater force.

During a final closure portion of the jaw closing movement, the angle ofthe second jaw 122 relative to the first jaw 121 changes, and anincreasing fraction of the total cable tension is transferred to thedistal end of the second jaw 122. This permits the shaft 130 at theproximal end of the second jaw 122 to move downwardly in the slots 126to provide a more uniform, final tissue compression. Because the tissueis initially compressed between the distal ends of the jaws andsubsequently along an increasing length portion of each jaw, the tissueis not initially forced distally in the jaws. Thus, the tendency of thetissue to slip out of the jaws, as would be the case in a conventionalpair of fixed pivot axis jaws, is eliminated or substantially minimized.

Another embodiment of the jaw assembly of the present invention isillustrated in FIGS. 11 and 12. The jaw assembly includes a first jaw171 and a second jaw 172. Each jaw has a distal end. A proximal end ofeach jaw is connected to the proximal end of the other jaw to define aunitary structure that includes a base 174. Each jaw 171 and 172 iscantilevered from the base 174 and is resiliently deflectable toward theother. The jaw assembly functions as a spring structure for urging thetwo jaws apart to an open position.

The first jaw 171 includes a first bearing member 176 which defines apair of spaced-apart, parallel grooves 178. Each groove defines agenerally semi-cylindrical, lateral guide surface for receiving aportion 180 of a cord 182.

The second jaw 172 includes a saddle or second bearing member 184defining a transverse, arcuate groove 186 for receiving an arcuatesegment 188 of the cord 182. The arcuate segment 182 connects the cordportions 180.

The cord portions 180 and the connecting arcuate portion 182 define aU-shaped configuration which is engaged with the second jaw bearingmember 184. The cord portions 180 may be characterized as trailingportions which each extend around the lateral guide surface defined bythe first bearing member 176. The two portions 180 are joined togetherproximally of the bearing member 176, as at knot 188. The jaw assemblyis thus relatively easy to fabricate and assemble.

When the cord 182 is pulled proximally, the jaws 171 and 172 close. Thisjaw assembly is especially suitable for use in closing ligating clips.The jaws can be closed with relatively high force, and the cablearrangement may be routed through an articulating instrument joint.Because the cord 182 can be engaged with the jaws relatively close tothe distal ends of the jaws, the closure force is applied relativelyclose to the location where the forces are most needed--especially whendeforming or crushing a ligating clip between the jaws.

Although the cord 182 is illustrated in FIGS. 11 and 12 as having asingle, proximally extending portion, it will be appreciated that eachof the portions 180 could extend separately along the jaw assembly andinto the instrument. Such portions 180 could be connected to form aendless loop in the proximal end of the instrument (not shown) whichcould be attached or engaged with a suitable operating lever in theproximal portion of the instrument (e.g., similar to the connection ofthe loop cord 96 to the operating lever 100 in the first embodimentillustrated in FIG. 2).

FIG. 13 illustrates a modification of the embodiment illustrated inFIGS. 11 and 12. The jaw assembly in FIG. 13 includes a unitarystructure defining a first jaw 171A and a second jaw 172A. This jawstructure is substantially identical to the structure of the jaws 171and 172 described above with reference to FIGS. 11 and 12. However, thefirst jaw 171A includes a laterally extending pin 190 in place of themember 176 illustrated in FIGS. 11 and 12. The pin 190 defines a lateralguide surface for engaging the trailing portions 180A of the cord 182A.

The cord portions 180A are connected with an arcuate section 182A whichextends over a member or saddle 184A mounted on the second jaw 172A. Thestructure of the member 184A is substantially identical to the structureof the member 184 described above with reference to the embodimentillustrated in FIGS. 11 and 12. The cord portions 180A are connectedproximally of the pin 190, as with the knot 188A. The jaw assemblyillustrated in FIG. 13 is operated in substantially the same manner asthe jaw assembly described above with reference to FIGS. 11 and 12.

Another embodiment of the jaw assembly of the present invention isillustrated in FIGS. 14 and 15. The jaw assembly has a first jaw 201 anda second jaw 202. Each jaw has a distal end and a proximal end. The jaws201 and 202 are mounted together at their proximal ends. Specifically,the proximal end of the second jaw 202 has a pair of downwardlyprojecting, side walls 204. Only the far side wall 204 is visible in thefigures. The walls 204 carry a pivot pin 206 that extends laterallybeyond the walls 204. The proximal end of the first jaw 201 defines apair of spaced-apart walls 208 exterior of the second jaw walls 204. Thefirst jaw walls 208 which define suitable bores (not visible) forreceiving the ends of the pivot pin 206.

A pin 210 is mounted to the walls of the first jaw 201 distally of thepivot pin 206. A roller 212 carried by the pin 210. The second jaw 202also has a pin 214 mounted distally of the pivot pin 206 in the walls204. A roller 216 is mounted on the pin 214.

A spring 218 is engaged with the first jaw 201 and with the second jaw202 in a manner that normally biases the second jaw 202 upwardly to theopen position illustrated in FIG. 14

An operating cord 220 is provided for closing the second jaw 202. Thecord 220 is looped through the bottom of the lower jaw 201 in the samemanner that the cord 151 is looped through the bottom 153 of the lowerjaw 121 in FIG. 8A described above. The two trailing portions of thecord 220 extend proximally through the jaw assembly. Specifically, eachtrailing portion of the cord 220 is trained sequentially from the fixedportion around the roller 216 and then around the roller 212. Therollers 216 and 212 function as guide surfaces. When the cord 220 istensioned, the second jaw 202 is pivoted to close relative to the firstjaw 201 as illustrated in FIG. 15.

Another embodiment of the jaw assembly present invention is illustratedin FIGS. 16 and 17. The jaw assembly includes a first jaw 231 having adistal end and proximal end, and the assembly includes a second jaw 232having a distal end and a proximal end. The proximal end of the firstjaw 231 defines a pair of side walls 234 (only the far side wall 234being visible in FIGS. 16 and 17). The proximal end of the second jaw232 is received between the first jaw side walls 234. The proximal endof the second jaw 232 also defines a pair of side walls 236 (only thefar side wall 236 being visible in FIGS. 16 and 17).

The side walls 236 of the second jaw 232 each define an elongate slot238 adjacent the proximal end. The first jaw 231 has a transverselyextending shaft or pin 240 adjacent its proximal end and received in theelongate slots 238 for mounting the jaws together to accommodatetranslation and pivoting movement of the second jaw 232 toward and awayfrom the first jaw 231.

The first jaw 231 has two spaced-apart guide surfaces or pins 242 and244 extending between the spaced-apart walls 234 at the proximal end ofthe first jaw 231. The second jaw 232 has a pin 246 at its distal endextending between the second jaw side walls 236 and has another pin 248which is located between the first pin 246 and the elongate slots 238and which extends between the second jaw side walls 236.

A V-shaped spring 250 is mounted so that interior angle at the apex ofthe V-shaped configuration receives the pin 240. The upper leg of thespring 250 is biased outwardly against the second jaw first pin 248, andthe lower leg of the spring 250 is biased outwardly against the firstjaw pin 242. This arrangement continuously biases the second jaw 232toward the open position.

An operating cord 254 is provided for closing the second jaw 232relative to the first jaw 231. The cord 254 has a closed loop 256 at itsdistal end, and the second jaw distal end pin 246 is engaged by the loop256. The operating cord 254 extends proximally in the second jaw 232toward the proximal end of the second jaw 232.

At the proximal end of the second jaw 232, the cord 254 is trainedaround the first jaw pin 242, then around the second jaw pin 248, andthen around the first jaw pin 244. The cord 254 extends proximally fromthe first jaw pin 244 into the proximal portion of the instrument (notshown) where it can be tensioned by suitable means (such as manually orwith an operating lever that may be similar to the lever 100 of thefirst embodiment of the jaw assembly described above with reference toFIG. 2).

When the cord 254 is tensioned, the second jaw 232 is pivoted downwardlyto the closed position illustrated in FIG. 17. When the tension on thecord 254 is released, the spring 254 urges the second jaw 232 to theopen position illustrated in FIG. 16.

Alternatively, the cord 254 may be provided as a continuous (endless)loop around the second jaw distal end pin 246, and the trailing portionsof the loop can extend together back to the proximal end around the pins242, 248 and 244 in the same manner as the single cord length describedabove. Both trailing portions would be tensioned together to operate thejaw assembly.

Another embodiment of the jaw assembly of the present invention isillustrated in FIGS. 18, 18A, and 19. The jaw assembly includes a firstjaw 261 having a distal end and a proximal end, and the assemblyincludes a second jaw 262 having a distal end and a proximal end. Theproximal end of the first jaw 261 defines a pair of spaced-apart sidewalls 264 and 265.

The second jaw 262 has a pair of spaced-apart walls 266 and 267projecting downwardly and received between the first jaw side walls 264and 265. A pivot shaft or pin 268 is mounted in the second jaw sidewalls 266 and 267. One end of the pin 268 is received in an elongateslot 271 defined in the first jaw side wall 264, and the other end ofthe pin 268 is received in an elongate slot 272 defined in the first jawside wall 265 (FIG. 18A). A roller 274 is disposed on the pin 268.

Located distally of the elongate slots 271 and 272 in the first jaw 261is a pin 278 which extends between, and which is mounted at each end to,the side walls 264 and 265. A roller 280 is disposed on the pin 278.

Located proximally of the elongate slots 271 and 272 in the first jaw261 are vertically spaced-apart pins 284 and 286. Each pin 284 and 286extends between, and is mounted in, the first jaw walls 264 and 265.Spaced above the pin 284 is a transverse guide member 288 which extendsbetween the first jaw walls 264 and 265.

A first operating cord 290 defines a loop around the jaws 261 and 262.In particular, the cord 290 has a bottom portion 292 engaged with thebottom of the first jaw 261. To this end, the bottom of the first jaw261, and a portion of each side of the jaw 261, define a groove orchannel 294 for receiving the cord 290 in a recessed relationship.

The cord 290 extends upwardly from the cord bottom portion 292 alongeach side of the jaw assembly, over the top of the second jaw 262 andback down along opposite sides of the second jaw 262. Preferably, areceiving channel or groove 296 is defined in the top and sides of thesecond jaw 262 for receiving the lengths of the cord 290.

Two portions of the cord 290 each extend downwardly along each side ofthe second jaw 262 from the top of the jaw 262 to the roller 280 carriedon the first jaw 261. The portions of the cord 290 then extendproximally from the roller 280 between the first jaw side walls 264 and265. The cord lengths 290 are engaged with the roller 274 on the pin 268and then extend between the pins 284 and 268 proximally of the elongateslots 271 and 272. The lengths of the cord 290 extend through a suitableslot 300 in the first jaw 261 and further into the instrument where theymay be tensioned manually or by suitable means. For example, theproximally extended lengths of the cord 290 can be joined together toform a continuous loop and may be attached in the proximal portion ofthe instrument to an operating lever (e.g., similar to the lever 100 ofthe first embodiment of the jaw assembly described above with referenceto FIG. 2).

A second operating cord 302 is attached to the proximal end of thesecond jaw 262. To this end, the second jaw walls 266 and 267 carry apin 306. The secondary operating cord 302 has a loop at its distal endengaged with the pin 306.

The cord is received between the guide member 288 and pin 284 in thefirst jaw 261, and the cord 302 extends proximally through a slot 308 inthe proximal end of the first jaw 161.

The proximal end of the cord 302 may be formed into a loop (notillustrated) in the proximal portion of the instrument for being pulledmanually or by means of a suitable lever or other mechanism.

Although not illustrated, it may be desirable in some applications toprovide a spring similar to the spring 250 described above withreference to the embodiment illustrated in FIGS. 16 and 17. Such aspring would bias the second jaw 262 upwardly to the open position.

In operation, the second operating cord 302 can be initially tensionedto pull the proximal end of the second jaw 262 upwardly and rearwardlyrelative to the pivot pin 268. The pivot pin 268 is maintained at theupper ends of the elongate slots 271 and 272 in the open position. Thejaw 262 can be maintained in this open position by maintaining tensionon the second operating cord 302 even if a biasing spring is notemployed to assist in opening the second jaw 262.

When it is desired to close the second jaw 262, tension is initiallystill maintained on the second operating cord 302. The tension isultimately released gradually, and in a timed manner, as tension isapplied to the first operating cord 290. However, initially, sufficienttension is maintained on the second operating cord 302 to keep the pin268 in the elevated position in the slots 271 and 272 so that the distalend of the second jaw 262 engages the tissue between the jaws before theproximal portion of the first jaw 262 engages the tissue. In thisrespect, when the second jaw 262 has moved to an intermediate closedposition, the second jaw 262 would be angled somewhat downwardly similarto the orientation shown for the jaw 122 in the second embodimentillustrated in FIG. 9.

As the tissue is compressed between the jaws, the total reaction forceson the second jaw 262 increase and the closing force required at thedistal end of the second jaw 262 must increase to effect furtherclosure. The clamping angle changes as the second jaw 262 closesfurther. This change in geometry results in an increasing fraction ofthe increasing tension in the first operating cable 290 beingtransferred to the distal end of the second jaw 262. The distal end ofthe second jaw 262 provides a tissue compression force which preventsthe tissue from slipping out of the jaws as the jaws close.

The tension in the second operating cable 302 is gradually released topermit the proximal end of the second operating jaw 262 to movedownwardly (under the increasing force applied by the first operatingcable 290). The pin 268 thus moves downwardly to the bottoms of theslots 271 and 272, and the jaws may then assume a substantially parallelorientation with the tissue clamped between the jaws.

FIGS. 20, 20A, and 20B illustrate another embodiment of the jaw assemblyof the present invention. The jaw assembly includes a frame 310 and afirst jaw 312 projecting transversely from the frame 310. A second jaw314 is carried on the frame 310 for moving toward and away from thefirst jaw 312 in an orientation generally fixed relative to the firstjaw 310.

A first guide member is carried on the first jaw 312 or frame 310, andin the embodiment illustrated, the first guide member is a pulley 316mounted for rotation on a shaft 318 carried in the stationary first jaw312. A second guide member 320 in the form of a pulley is mounted on ashaft 322 carried in the second jaw 314.

The second jaw 314 is normally biased to an open position relative tothe first jaw 312 by a compression spring 324. One end of thecompression spring 324 bears against a block 326 in the first jaw 312,and the other end of the spring 324 is received in a recess 328 definedin the second jaw 314.

The frame 310 (or lower portion of the stationary first jaw 312) definesan elongate slot 332. The bottom of the second jaw 314 includes aproximally projecting foot 334 which carries a pair of oppositelyprojecting pins 336. Each pin 336 is received in one of the slots 332.

An operating cord 340 is connected to the second jaw 314. In particular,the distal end of the cord 340 is secured to an anchor disk 342 receivedin a recess 344 defined in the exterior, distal face of the second jaw314. The cord 340 extends through a bore 346 in the second jaw 314, intothe first jaw 312 and around the guide member or pulley 316.

The cord 340 extends from the guide member 316 back into the second jaw314 and around the guide member or pulley 320 in the second jaw 314. Thecord 340 then extends through a bore 348 in the first jaw 312 to theproximal end of the instrument. Suitable mechanisms (not illustrated)may be provided in the instrument for assisting in pulling on the cord340 to effect closure of the jaws as illustrated in FIG. 20B.

The use of two pulleys 316 and 320 in the jaw assembly provides a 2 to 1mechanical advantage for applying the closure force to the jaw assembly.Owing to the use of a flexible cord 340, the jaw assembly can beprovided in an articulating instrument wherein the cord 340 canaccommodate articulation of the jaw assembly relative to the rest of theinstrument. To this end, a suitable, flexible cord 351 may extend fromthe instrument and connect to the jaw assembly for effectingarticulation of the jaw assembly. The detailed design and operation ofsuch an articulation system form no part of the present invention.

The jaw assembly illustrated in FIGS. 20, 20A, and 20B is particularlysuitable for incorporating linear stapler components wherein staples areprovided in a conventional or special cartridge (not illustrated). Forexample, a conventional cartridge of staples (not illustrated) can beheld in the first jaw 312, and the staples can be applied to tissuebetween the jaws and deformed against the second jaw 314 which would actas an anvil. A suitable conventional or special staple cartridge firingsystem may be provided, and this can include an actuating cable 352. Theincorporation of such a stapler system in the jaw assembly, and thedetailed design and operation of such a stapler system, form no part ofthe present invention.

A modified jaw assembly somewhat similar to that illustrated in FIGS.20, 20A and 20B is illustrated in FIG. 21. The assembly illustrated inFIG. 21 does not provide a 2 to 1 mechanical advantage, however. The jawassembly includes a frame 410 and a first, stationary jaw 412. The firstjaw 412 projects transversely from the frame 410.

A second jaw 414 is carried on the frame 410 for movement toward andaway from the first jaw 412 in an orientation fixed relative to thefirst jaw 412. A guide member in the form of a pulley 420 is mounted ona pin 422 carried in the second jaw 414.

The first jaw 412 defines a slot 432. The second jaw 414 defines a foot434 having a guide block 435 received in a cavity in the lower part ofthe first jaw 412. Pins 436 project laterally outwardly from the block435. The pins 436 are disposed within slots 432 in the first jaw 412. Acompression spring 437 is mounted in each slot to bias each pin 436, andhence the second jaw 414, distally to the open position illustrated inFIG. 21.

An operating cord 440 has a distal end connected to the stationary firstjaw 412, as with a clamp bracket 439. The cord 440 is trained around thepulley 420 and extends through a bore 448 defined in the first jaw 412.The cord 440 extends to the proximal portion of the instrument where itmay be engaged with a suitable operating mechanism or manually pulled soas to tension the cord and pull the second jaw 414 to a closed positionagainst the first jaw 412. A linear stapling system, which may includean operating cord 452, may be provided in the jaw assembly as describedabove with reference to the embodiment illustrated in FIGS. 20, 20A, and20B.

Further, if desired, the jaw assembly illustrated in FIG. 21 may bemounted so as to articulate on an instrument. The particular design andoperation of such an articulating system form no part of the presentinvention.

Another embodiment of the jaw assembly of the present invention isillustrated in FIGS. 22-24. This embodiment of the jaw assembly effectsclosure of a pair of jaws in a substantially parallel relationship. Thejaw assembly includes a first rod 501 having a first axial portion 502defining a right-hand thread and having a second axial portion 503defining a left-hand thread. Preferably, the jaw assembly also includesa second rod 506 having a first axial portion 508 defining a firstright-hand thread and having a second axial portion 510 defining aleft-hand thread. A first jaw 510 defines a first right-hand threadedbore 512 for receiving and threadingly engaging the first rod firstaxial portion 502. The first jaw 510 also defines a second right-handthreaded bore 514 for receiving and threadingly engaging the second rodsecond axial portion 508.

The assembly includes a second jaw 516. The second jaw 516 defines afirst left-hand threaded bore 518 for receiving and threadingly engagingthe first rod second axial portion 503. The second jaw 516 also definesa second left-hand threaded bore 520 for receiving and threadinglyengaging the second rod second axial portion 509.

A first pulley 524 is mounted to the first rod 501 and fixed thereto.Similarly, a second pulley 526 is mounted to the second rod 506 and isfixed thereon. An operating cord 530 is trained around the first pulley,preferably 11/2 times. Similarly, the operating cord 530 is trainedaround the second pulley 526 at least once.

Two portions of the cord 530 extend rearwardly into the proximal portionof the instrument (not illustrated) for being manipulated (manually orby a suitable operating device) to rotate the pulleys 524 and 526together in one direction or the opposite direction. In one direction ofrotation the jaws 510 and 516 will be moved together to the closedposition (FIG. 24). In the opposite direction of rotation, the jaws willbe moved apart to the open position (FIG. 22). If desired, a thin,cogged belt (not illustrated) could be disposed in the bottom of thepulleys 524 and 526 to insure synchronization of the pulleys and providea better gripping surface.

This jaw assembly design provides a relatively simple construction andaccommodates closure of the jaws in a substantially parallel manner withreduced clamping forces.

This jaw assembly design allows the use of high tensile cord andaccommodates the use of the jaw assembly in an articulating instrumentin which the jaw assembly can be articulated relative to the instrumentwhile the flexible cord portions 530 accommodate the articulation.

If the jaw assembly is used in an articulating instrument, the proximalpulley rod 506 may be employed as an articulation pivot joint for theassembly. Then any cord sheaths and guides could be located proximallyof the pulley 526 to save space and increase the potential articulationangle that could be accommodated.

FIG. 25 illustrates a further embodiment of the jaw assembly of thepresent invention. The assembly includes a first jaw 601 having a distalend and a proximal end, and a second jaw 602 having a distal end and aproximal end. The second jaw 602 is mounted for pivoting movement on thefirst jaw 601. To this end, the proximal end of the first jaw 601includes a pair of spaced-apart walls 604 which each define a bore 606for receiving a pivot pin 610. The proximal end of the second jaw 602defines a pair of walls 614 which are spaced apart by an amount lessthan the spacing between the first jaw walls 604. The second jaw walls614 are adapted to be received between the first jaw walls 604.

The second jaw wall 614 define bores 618 for receiving the pivot pin610. The second jaw walls 614 also define another pair of bores 620 forreceiving a pin 622. A roller 624 is disposed on the pin 622 between thewalls 614.

The first jaw walls 604 define a pair of bores 630 for receiving a pin632. A roller 636 is mounted on the pin 632.

An operating cord 640 is provided for operating the jaw assembly. Thecord 640 includes a first portion in the form of a flexible, cylindricalfilament 642. The cord 640 also includes a second, distal portion in theform of a flexible, metallic band 646. The distal end of the filament642 is tied to, or otherwise attached to, the proximal end of the band646. The band 646 extends along the length of the second jaw 602 andterminates in an anchor disc 648. The anchor disc 648 includes a plug650 for being received in an aperture 652 defined at the distal end ofthe second jaw 602.

In the assembled condition, the filament 642 is positioned below thepivot pin 610. The proximal end of the metallic band 646 is positionedbelow the roller 636 carried on the first jaw 601. The band 646 has agenerally Z-shaped configuration and is trained over the roller 624carried in the second jaw 602. Preferably, a torsion spring 656 ismounted on the pin 610 to normally urge the second jaw 602 to pivotupwardly to carry the distal end of the second jaw 602 away from thefirst jaw 601.

The jaw assembly can be closed by pulling on the filament 642 from theproximal portion of the instrument. Suitable mechanisms (notillustrated) may be provided for engaging the proximal portion of thefilament 642 in the proximal portion of the instrument. For example,this could include an operating lever similar to the lever 100 of thefirst embodiment of the jaw assembly described above with reference toFIG. 2.

FIG. 26 illustrates another embodiment of the jaw assembly of thepresent invention. The jaw assembly includes a first jaw 701 having adistal end and having a proximal end defining a pair of spaced-apartwalls 703. The walls 703 define a first pair of aligned apertures 705for receiving a pivot pin 707. The walls 703 define a second pair ofapertures 709 for receiving another pin 711.

A second jaw 712 has a distal end and has a proximal end which ispivotally mounted to the proximal end of the first jaw 701. To this end,the proximal end of the second jaw 712 includes a pair of walls 716 forbeing received between the first jaw walls 703. The second jaw walls 716also define a pair of bores 718 for receiving the pivot pin 707.

An operating cord 724 is provided for operating the jaw assembly. Theoperating cord 724 includes a proximal portion in the form of a thin,cylindrical, flexible filament 726 and a distal portion in the form of aflexible, metallic band 730. The distal end of the filament 726 is tiedto, or otherwise secured to, the proximal end of the band 730. Thefilament 726 and band 730 are disposed under the pivot pin 707 and underthe other pin 711. Preferably, a roller 734 is disposed on the pin 711for contacting the band 730.

The distal end of the band 730 is secured by suitable means to thesecond jaw 712. In one contemplated form of connection, the second jaw712 defines a slot 738 into which a distal end portion of the band 730is disposed and held by means of an insert wedge (not illustrated).

Preferably, the band 730 has a generally Z-shaped configuration. Aspring, such as a torsion spring 739, can be provided to normally urgethe second jaw 712 to an open position. The jaw 712 can be closed bypulling on the filament 724 from the proximal portion of the instrument.

FIGS. 27-30 illustrate another embodiment of jaw assembly of the presentinvention. The assembly includes a first jaw 801 having a distal end anda proximal end, and includes a second jaw 802 having a distal end and aproximal end. The proximal end of the first jaw 801 includes a pair ofside walls 804 (FIG. 30). Each wall 804 defines an elongate slot 806.

The first jaw 801 also includes a first guide pin 808 located distallyof the slots 806 and extending between the walls 804. A pair ofspaced-apart sleeves or rollers 810 are disposed on the pin 808 (FIGS.27 and 30).

A second guide pin 814 is located proximally of the slots 806 in thefirst jaw 801. The second guide pin 814 extends between the first jawwalls 804. A roller or sleeve 816 is mounted on the pin 814.

Finally, an upper pin 818 is mounted between the first jaw walls 804above the pin 814.

The second jaw 802 includes a pair of side walls 822. The walls 822 arespaced-apart by an amount that is less than the spacing between thefirst jaw walls 804. Mounted between the second jaw side walls 822 is apivot pin 824. The distal ends of the pin 824 extend into the slots 806in the side walls 804 of the first jaw 801. Two sleeves or rollers 826are mounted on the pin between the second jaw walls 822. The rollers 826are spaced apart at the center.

The second jaw 802 includes a third guide pin 830 located distally ofthe slots 806 and extending between the second jaw walls 822. Twosleeves or rollers 832 are disposed on the pin 830. The rollers 832 arespaced apart at the middle of the pin 830.

A V-shaped spring 840 is mounted between the first jaw 801 and secondjaw 802. The spring 840 is mounted so that the interior angle at theapex of the V-shaped configuration of the spring receives the pivotshaft 824 between the spaced-apart rollers 826.

The upper leg of the spring 840 is biased outwardly against the secondjaw guide pin 830 between the two spaced- apart rollers 832. The end ofthe other leg of the spring 840 is biased outwardly against the firstjaw guide pin 808 between the two spaced-apart rollers 810. Thisarrangement tends to continuously bias the second jaw 802 toward theopen position (FIGS. 27 and 30).

A first operating cord 850 has two portions or lengths extending intothe proximal end of the first jaw 801, one length on each side of thespring 840. Each length has a first portion extending between the pin814 and pivot shaft 824. Each first portion of the cord 850 engages theroller 816 on the pin 814 and the roller 826 on the pivot shaft 824.

Each portion of the cord 850 extends distally from the pivot shaft 824and sequentially around the guide pin 808 on the first jaw 801 and thenaround the guide pin 830 on the second jaw 802. The cord engages theroller 810 on the pin 808 and engages the roller 832 on the pin 830.

The cord extends from the guide pin 830 on the second jaw 802 down tothe bottom of the first jaw 801 on each side of the spring 840. To thisend, the bottom of the jaw 801 define two spaced-apart bores 856 (FIG.30) to accommodate passage of a portion of the cord 850. As shown inFIG. 30, the downwardly extending portions of the cord 850 define acommon horizontal portion 858 below the first jaw 801. As viewed in FIG.30, the portions of the cord 850 in the bottom of the first jaw 801define a generally U-shaped configuration around a bottom portion of thefirst jaw 801.

The portions of the operating cord 850 extending proximally of the jawassembly can be joined together to form a continuous loop and may beattached in the proximal portion of the instrument (not illustrated) toan operating lever (e.g., similar to the lever 100 of the firstembodiment of the jaw assembly described above with reference to FIG.2).

A second operating cord 860 is connected to the second jaw 802.Specifically, the proximal end of the second jaw 802 includes a pin 862extending between the walls 822. The second operating cord 860 is loopedaround the pin 862 and extends to the proximal portion of the instrument(not illustrated). The proximally extending lengths of the secondoperating cord 860 may be joined together to form a continuous loop andmay be attached in the proximal portion of the instrument to anoperating lever (e.g., similar to the lever 100 of the first embodimentof the jaw assembly described above with reference to FIG. 2).

The second jaw 802 can be maintained in the maximum open position asillustrated in FIG. 27 by maintaining tension on the second operatingcord 860. This ensures that the pivot shaft 824 is at the top of theslots 806 in the first jaw 801 and that the second jaw 802 is pivoted ina clockwise direction as viewed in FIG. 27 to a fully opened position.

When it is desired to close the jaw assembly, tension is applied to thefirst operating cord 850. Initially, sufficient tension is alsomaintained on the second operating cord 860 to hold the pivot shaft 824in the elevated position in the slots 806. In a nearly closed position,the distal end of the second jaw 802 will be angled downwardly near thefirst jaw 801 as shown in FIG. 28. The proximal end of the second jaw802 remains elevated owing to the continued application of tension tothe second operating cord 860.

Because the distal end of the second jaw 802 engages the tissue on thefirst jaw 801 prior to the proximal portion of the second jaw 802engaging the tissue, the tissue is initially clamped near the distal endof the jaws and prevented from being forced outwardly along the jaws.

When the tissue has been sufficiently compressed by the downwardlyangled, distal end of the second jaw 802, the tension in the secondoperating cord 860 is gradually released while the tension on the firstoperating cord 850 is maintained or increased. This procedure may beeffected in response to tactile sensation or visual observation. Thisprocess may also be effected by suitable devices for automaticallytiming the release of tension in the second operating cord 860.

When sufficient tension has been released in the second operating cord860, the proximal end of the second jaw is pulled downwardly owing tothe tension in the first operating cord 850. The pivot shaft 824 movesto the bottom of the slots 806 in the first jaw 801. The second jaw 802can then assume a substantially parallel orientation relative to thefirst jaw 801.

In the above-described embodiments, the cords, or portions of the cords,are preferably made from materials which are non-toxic and which havegood physical, chemical, radiological, and biological characteristics.Some of the materials that may be used are the cobalt sterilizable,non-toxic, liquid-crystal, polyester-polyarylate polymer materials soldin the United States of America under the tradenames VECTRAN and VECTRAby Hoechst Celanese which has an office in Bridgewater, N.J., U.S.A.These materials also appear to exhibit a strength, resistance to creep,and thermal expansion coefficient which are especially suitable for usein surgical instruments.

It will be readily apparent from the foregoing detailed description ofthe invention and from the illustrations thereof that numerous othervariations and modifications may be effected without departing from thetrue spirit and scope of the novel concepts or principles of thisinvention.

What is claimed is:
 1. A jaw assembly for a surgical instrument, saidassembly comprising:a pair of jaws in which at least one jaw ispivotable relative to the other about a pivot axis; and an operatingcord defining an endless loop with one portion engaged with said onepivotable jaw at a location spaced from said pivot axis and with anotherportion adapted to be engaged so as to tension said loop to effectpivoting of said one pivotable jaw.
 2. A jaw assembly for a surgicalinstrument, said assembly comprising:a pair of jaws, one of said jawsbeing movable relative to the other; and an operating cord operativelyconnected with said movable jaw, said cord having an endless loopconfiguration having one portion of the loop operatively engaged withsaid movable jaw and having another portion of the loop adapted to beengaged so as to apply tension to at least part of said loop to effectmovement of said one movable jaw.